{
"Npi": {
"NPI": "1841260940",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIFETEAM INDIANA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "836 4TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUNTINGTON",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "25701-1407",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "28 W CHURCH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CAMBRIDGE CTY",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "47327-1615",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "765-478-3800",
"PracticeLocationAddressFaxNumber": "765-478-3880",
"EnumerationDate": "01/23/2006",
"LastUpdateDate": "04/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RICH",
"AuthorizedOfficialFirstName": "BRIEANN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF OPERATIONS",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NREMT I",
"AuthorizedOfficialTelephoneNumber": "765-478-3800",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "341600000X",
"TaxonomyName": "Ambulance",
"LicenseNumber": "0922",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "0922",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}